The principles of treatment in the ureteral stones

Abstract

Introduction and objectives: It hasn’t been decided yet the place of modern (endoscopic, ESWL) and traditional methods of therapeutical treatment of ureteral stones. The aim of this study was to improve the treatment of ureteral stones with the creation of a therapeutic algorithm. Material And Methods: In this study we analized a group of 325 patients with ureteral stones, treated in a conservative (47), endoscopic (65), surgical (71) and ESW L (142) way. Age range from 23 to 67 years old, with an average of 45 years. There were 173 (53,2% ) females and 152 (46,8%) males. The stones were localized in 77 (23,8%) of cases - lumbar floor, in 50 (15,4%) of cases - iliacus, in 175 (54,0%) of cases - pelvic and in 22 (6,8%) of cases - intramural. The diameter of the stones ranged from 0,3 to 2,0 cm (3-20mm). The staying time for the stones in the ureters varied from 7 days to 2 years. Ten (4,7%) of the patients had ureteral catheter, 56 (28,0%) - had ureteral autostatic stent, 159 (75,0%) - ESWL, 13 (4,0%) percutaneous nephrostomy, 8 (1,5%) open nephrostomy, 72 (22,2%) - ureterolitotomy, 60 (18,5%) - ureteroscopy, meatotomy - 5 (1,5). The patients were followed up for a range of period from 3 months to 2 years. The analyzing criteria of the rezults were: success rate, fail number, complications and the way of their solving. Results: We have studied the rezults of the ureteral stones treatment, which was a basis for creating a therapeutical algorithm, according to the size, localization and time of staying in ureter. A differencial application of these therapeutic methods allows to improve considerably the data. The success rate was of 86,9%; complications were noted in 13,1% of cases. Conclusions: The utilization of therapeutical algorithm allows to choose the optimal therapeutic method of treatment in ureteral stones.